Peaceful Program

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number: Include Country Code
Please enter a valid phone number.
4
Age* This field is required.
5
Date of Birth* This field is required.
6
Occupation* This field is required.
7
Address* This field is required.
Time Zone
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
Where did you hear us from?* This field is required.
Google Search
Facebook
Instagram
Referal
Other
9
If you were referred, please let me know their name.
10
I am looking for:* This field is required.Please Choose Which Areas Of Life You Are Looking For Assstance With. It can be More Than One.
Peaceful Self Awakening
Peaceful Health Awakening
Peaceful Relationship Awakening
Peaceful Abundance Awakening
Peaceful Spirituality Awakening
Peaceful Embodiment Program
I would like a recommendation
11
The ideal Length of my Sessions would be:* This field is required.
1 Topic: 1 Month
1 Topic: 3 Months
Multiple Topics: 3 Months Each
Multiple Topics: 1 Month Each
I am not yet sure.
12
What would your ideal outcome at the end of the session be?* This field is required.This can be at all levels of health: physical wellness, emotional, spiritual, purpose, abundance or other.
Huge
Large
Normal
Small
Ok
Ok
13
How Many Hours A Week Can you dedicate to Your Peaceful Journey?* This field is required.This includes sessions, follow-ups and implementing techniques such as meditation or journaling in your own time
1-2 hours a week
2-4 hours a week
4-7 hours a week
I will spend as much time as is needed
I do not have that much time
14
How committed are you into putting gentle effort into achieve your goals?* This field is required.
Somewhat
Moderately
Very
I want to but I am going to need accountability and motivation. With this, I will put in the work.
15
Are you ready to invest financially in yourself?* This field is required.
Yes! I am Ready to Begin.
I am Serious But I would need a Payment Plan
I Don’t Have the Finances Yet and Might Struggle to Invest Consistently
16
Before I Book* This field is required.I would like Some Guidance:
Please Give Me An Email Recommendation
Let us Book A Call To See Which Option is Best
I Know the Session Mentioned Above Is Exactly What I need and Ready To Move Forward!
17
Do you have any questions for me?This can be at all levels of health: physical wellness, emotional, spiritual, purpose, abundance or other.
18
Signature* This field is required.Scope of Services and Medical Disclaimer: Megan Bailey is a medical intuitive and energy healing consultant, not a physician or psychologist. The services provided focus on wellness, prevention, and holistic support rather than the treatment or diagnosis of specific medical conditions. If you suspect you have an ailment or illness requiring medical attention, please consult a licensed physician. Only a licensed physician can prescribe medication, and any mention of drugs or supplements during consultations is solely for understanding your current regimen and not for evaluating the appropriateness of your medication. Decisions regarding prescription changes should always be made with your physician. Megan Bailey’s approach emphasizes non-toxic, natural nutritional therapies and energetic practices to support optimal health and prevent illness. The aim is to educate and motivate clients to take personal responsibility for their health through a positive attitude, lifestyle choices, and dietary practices. All advice provided should be considered at your own discretion. Discussions about health conditions during sessions are on an energetic level and should not be interpreted as a medical diagnosis. These sessions are not guaranteed to cure or prevent illness. While many clients experience improvements in health and well-being, Megan Bailey does not guarantee protection from future health issues. By signing below, you acknowledge that you understand Megan Bailey is not a medical doctor or psychologist. You agree to seek medical attention if needed and recognize that Megan Bailey will not be held liable for any failure to diagnose, treat, or prevent illness. Confidentiality and Disclosure: You have the right to confidential treatment, and your privacy will be maintained. Confidentiality will be upheld unless client consent is given, or if there is a clear and imminent danger to yourself or others, or as otherwise required by law. If there is any intention of self-harm or if you are experiencing suicidal thoughts, it is your responsibility to seek immediate help from a licensed mental health professional or appropriate support services. Megan Bailey will not provide mental health crisis intervention and is not liable for failure to address such issues. You are expected to disclose any intentions of self-harm so appropriate referrals can be made if necessary. Payment and Cancellation Policies: The consultation fee is due before the session. Cancellations made less than 24 hours before the appointment will incur a charge. Communication and Support: Megan Bailey is available for brief, general support between sessions but cannot offer comprehensive assistance via email or outside of scheduled sessions. Acknowledgment and Responsibility: By signing below, you confirm that you understand Megan Bailey’s role as a spiritual mentor and energy healer, not as a medical or psychological professional. You agree to seek medical advice if needed and acknowledge that Megan Bailey will not be liable for any health conditions or failures to diagnose or treat illness. You commit to providing accurate information about your medical conditions and medications and release Megan Bailey from responsibility for your individual response to the energies and information received. Program Participation and Refunds: Payment for sessions should be made at least 3 days in advance to secure your spot. Any session cancellations should be made with at least 24 hours’ notice to avoid charges. If joining a program or group coaching, you agree that it aligns with your goals. Refunds of 50% are available within the first week of participation; no refunds will be issued beyond this period.
19
Consent* This field is required.By checking this box and submitting this form, I hereby consent to receive email communications and promotional materials from Shed and Shift at the email address provided above. I understand that I can unsubscribe from these communications at any time by following the instructions provided in the emails*This field is required.
Yes
Should be Empty: